A single piece of paper is being used in the fight to save us from certain doom.

Since the discovery of penicillin, antibiotics have played a major role in treating infectious diseases and improving life expectancy.

But overuse of antibiotics is contributing to an alarming rise in the rate of superbug resistance, said Robert Parker, manager of the Antimicrobial Stewardship Program (ASP) in the Regina Qu’Appelle Health Region.

“The end is in sight for this form of treatment,” he said.

Antibiotics should be used to treat bacterial infections, but they don’t work on viruses. Every time an antibiotic is taken unnecessarily, it gives bacteria an opportunity to form resistance to it, Parker said.

He doesn’t want to go back in time to when a scratch could kill.

To add to the dilemma, there’s a real void in the development of new antibiotics, he said.

Part of the problem is that doctors, nurse practitioners and pharmacists feel pressured by patients asking for a pill when they’re ill.

A survey was done to assess if family doctors, dentists, nurse practitioners, community pharmacists and even veterinarians understand antimicrobial stewardship.

The survey also tried to determine what could be done to decrease unnecessary use of antibiotics, said Dr. Casey Phillips, a senior pharmacist with the Regina Qu’Appelle Health Region.

Consequently, the ASP developed the viral prescription pad — a four-by-six sheet of paper designed to look like a prescription — to help prescribers when treating and educating patients with viral infections.

The slip of paper has the patient’s name on it, information about managing symptoms of of viral infections, the duration a patient can expect to feel ill and when it’s appropriate to go back and see the doctor, Phillips said.

“Patients have become quite used to seeing their doctor and getting an antibiotic when they’re feeling unwell,” he said. “For many patients, they find it surprising to go to their doctor and not get a prescription.”

Superbugs, such as methicillin-resistant staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), are frequently in hospitals and the community.

“We needed to raise awareness, not only in the clinical setting, but within the community as well,” Parker said. “There are a lot of misconceptions around antibiotic use.”

In North America, about 70 per cent of antimicrobials are prescribed in the community. Of that 70 per cent, between 30 and 50 per cent are prescribed to people who don’t require them.

“It’s scary because we know that the more antibiotics that we use the more antibiotic resistance you see in bacteria,” said Jason Vanstone, a research analyst with the region.

The province doesn’t have a promising track record.

Saskatchewan has the second-highest community-prescribing rate in Canada for antimicrobials, which are primarily antibiotics, but can also include antivirals and antifungals.

“If we’re using antibiotics at such a high rate in our province, we’re opening the doors to having high rates of antibiotic resistance,” Vanstone said.

The team is asking patients to go to their doctors and ask for a plan to treat their symptoms, not a pill.

The viral prescription pad is an excellent tool that has been picking up a lot of traction in the community, but it’s just one piece of the puzzle, Phillips said.

The team has undertaken a number of initiatives to educate health-care professionals and community members.

For example, Phillips and Vanstone do presentations about antibiotic overuse to students and staff at high schools.

“Dr. Alex Wong and I attend rounds in the intensive care unit to improve antibiotic usage there as well as other wards throughout the hospital,” Phillips said. “And then we also have interventions in our nursing homes to make sure we’re not inappropriately using antibiotics there.”

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